Treatment of Psychological Disorders

1. Treatment ofPsychological Disorders

2. Types of Treatment • Psychotherapy • Insight therapies • “talk therapy” • Behavior therapies • Changing overt behavior • Biomedical therapies • Biological functioning interventions

3. Who Seeks Treatment? • 15% of U.S. population in a given year • Most common presenting problems • Anxiety and Depression • Women more than men • Medical insurance • Education level

4. Figure 15.1 Treatment seeking for various disorders.

5. Figure 15.2 Therapy utilization rates

6. Figure 15.3 Psychological disorders and professional treatment

7. Who Provides Treatment? • Clinical psychologists • Counseling psychologists • Psychiatrists • Clinical social workers • Psychiatric nurses • Counselors

8. Insight Therapies: Psychoanalysis • Sigmund Freud and followers • Goal: discover unresolved unconscious conflicts • Free association • Dream analysis • Interpretation • Resistance and transference

9. Figure 15.4 Freud’s view of the roots of disorders

10. Insight Therapies: Client-Centered Therapy • Carl Rogers • Goal: restructure self-concept to better correspond to reality • Therapeutic Climate • Genuineness • Unconditional positive regard • Empathy

11. Figure 15.5 Rogers’s view of the roots of disorders

12. Therapies Inspiredby Positive Psychology • Martin Seligman • Uses theory and research to better understand the positive, adaptive, creative, and fulfilling aspects of human existence • well-being therapy • positive psychotherapy • can be an effective treatment for depression

13. Figure 15.6 Positive psychotherapy for depression

14. Behavior Therapies • B.F. Skinner and colleagues • Goal: unlearning maladaptive behavior and learning adaptive ones • Systematic Desensitization – Wolpe • Classical conditioning • Anxiety hierarchy • Aversion therapy • Alcoholism, sexual deviance, smoking

15. Figure 15.7 The logic underlying systematic desensitization

16. Behavior Therapy • B.F. Skinner and colleagues • Social skills training • Modeling • Behavioral rehearsal

17. Cognitive-Behavioral Therapy • Aaron Beck • Cognitive therapy • Goal: to change the way clients think • Detect and recognize negative thoughts • Reality testing • Kinship with behavior therapy

18. Figure 15.11 Beck’s view of the roots of disorders

19. Biomedical Therapies • Psychopharmacotherapy • Antianxiety - Valium, Xanax, Buspar • Antipsychotic - Thorazine, Mellaril, Haldol • Tardive dyskinesia • Clozapine • Antidepressant: • Tricyclics – Elavil, Tofranil • Mao inhibitors (MAOIs) - Nardil • Selective serotonin reuptake inhibitors (SSRIs) – Prozac, Paxil, Zoloft

20. Biomedical Therapies • Psychopharmacotherapy • Mood stabilizers • Lithium • Valproic acid • Electroconvulsive therapy (ECT) • Transcranial magnetic stimulation • Deep brain stimulation

21. Figure 15.13 Antidepressant drugs’ mechanisms of action

22. Figure 15.15 Deep brain stimulation

23. Current Trends and Issues in Treatment • Managed care • Empirically validated treatments • Blending approaches to treatment • Multicultural sensitivity • Deinstitutionalization • Revolving door problem • Homelessness

24. Figure 15.17 The leading approaches to therapy among psychologists

25. Figure 15.19 Declining inpatient population at state and county mental hospitals

26. Figure 15.20 Estimates of the effectiveness of various approaches to psychotherapy.